I was on DDI, Ziagen and 3TC for several years and noticed moderate facial lipoatrophy, but it did not really seem to be getting worse. After a rebound in my viral load my doctor dropped the DDI and left me on the 3TC and Ziagen and added Kaletra and Viread. It looks to me like my lipoatrophy is getting worse again. Is this my own imagination, or does it occur with this combo or perhaps is it more likely to happen when starting a new regime? (I've been on this new regime for 2 months now)
CD4=100 and VL 5000 Thanks

Response from Dr. Moyle

Its difficult to know with these uncommon combinations but certainly abacavir, 3TC and tenofovir are generally considered benign for lipoatrophy. The culprit my be the Kaletra. It is worth discussing with your doctor if atazanavir/ritonavir (300/100mg QD) will do the job....this will depend on past resistance in your virus to protease inhibitors. Atazanavir has less effects on metabolism that Kaletra so should reduce the risk of lipodystrophy getting worse
regards
Graeme Moyle

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